Healthcare Provider Details

I. General information

NPI: 1164387866
Provider Name (Legal Business Name): SAINT LUKES MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 AVE TITO CASTRO
PONCE PR
00716-4717
US

IV. Provider business mailing address

917 AVE TITO CASTRO
PONCE PR
00716-4717
US

V. Phone/Fax

Practice location:
  • Phone: 787-844-2080
  • Fax: 787-844-2090
Mailing address:
  • Phone: 787-844-2080
  • Fax: 787-844-2090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: RAFAEL SAMUEL ALVARADO
Title or Position: DIRECFTOR EJECUTIVO OPERACIONAL
Credential:
Phone: 787-848-5600